Colorectal Health Awareness Month

Chinese Medicine and the Early Detection of Colorectal Cancer

For thousands of years, tongue diagnosis has played an important role in the practice of Traditional Chinese Medicine. TCM practitioners often rely on tongue diagnosis to differentiate syndromes by examining variations in the tongue’s color, texture, shape and coating to evaluate a patient’s condition.

According to researchers at Carnegie Mellon University & the University of Pittsburgh Medical Center, changes in the tongue may prove to be particularly helpful as an early warning sign in the early detection of colorectal cancer.  The tongue is one of the first parts of the GI tract that’s visible, so changes in its appearance or texture are an important indicator.  Early detection of cancer is important. Often called “the silent killer” colorectal cancer is the third most diagnosed cancer in the West and can develop over years, while exhibiting few symptoms.

In what is believed to be the first study of its kind in the United States, investigators have begun taking computerized images of patients’ tongues to determine if an examination can provide an early indication of colon cancer.

Tongues are photographed with a calibration chart to confirm color before being analyzed by Yang Cai, PhD, a systems scientist at Carnegie Mellon. Determined to learn more about the relationship between the appearance of the tongue and certain cancers, Dr. Cai talked to Chinese medical experts and collected volumes of medical literature. One intriguing study, published in the Chinese-language Journal of Oncology in 1987, examined the tongues of more than 12,000 patients and found “significant changes” in color, coating and texture in the tongues of cancerous patients compared to those without cancer.

The results of Cai’s informal investigation led him to Dr. Robert Schoen, director of colorectal and gastrointestinal cancer prevention and control research at the University of Pittsburgh Cancer Institute (UPCI). While Schoen admits to some skepticism, he allowed Cai to add his research project to Schoen’s ongoing study with the Early Detection Research Network. If tongue screening proves accurate, it would give providers an inexpensive, noninvasive alternative to a traditional colonoscopy.

“From a clinical standpoint, it’s not really much of a burden to the patients to stick out their tongue and have a picture taken,” Schoen explained. “If one could see some characteristics of the tongue correlated to the presence of adenomatous polyps that have the potential to transform into cancer that would be great. Then you could just go around and take pictures of people’s tongues. That’s a lot simpler than doing colonoscopies.”

For Dr. Cai, the goal of his project is not to replace the conventional means of detecting colorectal cancer simply by looking at the tongue, but rather as an alternative screening method that can accurately and effectively produce an early warning sign. That sign may be as simple as having a patient see a physician for a more complete evaluation, but it may make a significant difference in terms of cancer treatment, intervention, and a positive outcome of care.

For more information on the tongue diagnosis research project, contact Dr. Cai at .


Snowbeck C. Researchers exploring whether tongue can reveal colon cancer. Pittsburgh Post-Gazette October 1, 2002.

12,448 cases of the clinical observation of cancer patients’ tongues. Journal of Oncology (Chinese) 1987;7(3).